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Aims Little is known about the trade-off between the health benefits of physical activity (PA) and the potential harmful effects of increased exposure to air pollution during outdoor PA. We examined the association of the combined effects of air pollution and changes in PA with cardiovascular disease (CVD) in young adults. Methods and results This nationwide cohort study included 1 469 972 young adults aged 20–39 years. Air pollution exposure was estimated by the annual average cumulative level of particulate matter (PM). PA was calculated as minutes of metabolic equivalent tasks per week (MET-min/week) based on two consecutive health examinations from 2009 to 2012. Compared with the participants exposed to low-to-moderate levels of PM2.5 or PM10 who continuously engaged in ≥1000 MET-min/week of PA, those who decreased their PA from ≥1000 MET-min/week to 1–499 MET-min/week [PM10 adjusted hazard ratio (aHR) 1.22; 95% confidence interval (CI) 1.00–1.48] and to 0 MET-min/week (physically inactive; PM10 aHR 1.38; 95% CI 1.07–1.78) had an increased risk of CVD (P for trend <0.01). Among participants exposed to high levels of PM2.5 or PM10, the risk of CVD was elevated with an increase in PA above 1000 MET-min/week. Conclusion Reducing PA may lead to subsequent elevation of CVD risk in young adults exposed to low-to-moderate levels of PM2.5 or PM10, whereas a large increase in PA in a high-pollution environment may adversely affect cardiovascular health.

Background and Aims:The effect of sarcopenic visceral obesity on risk of nonalcoholic fatty liver disease (NAFLD) is uncertain. We investigated whether: a) the skeletal muscle mass to visceral fat area ratio (SV ratio), as a measure of sarcopenic visceral obesity, is a risk factor for NAFLD; and b) the SV ratio adds to conventional adiposity measures to improve prediction of incident NAFLD.Methods: Adults without NAFLD (n=151,017) were followed up for a median of 3.7 years.

Heavy alcohol intake may be associated with lower BMD in men while light alcohol intake may associate with higher BMD among women. Future longitudinal studies investigating the effect of alcohol consumption on bone mineral density are needed to validate the findings of this study.

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Cancer survivors are at an increased risk for cardiovascular disease (CVD). However, the association between particulate matter (PM) and CVD risk among cancer survivors (alive >5 years since diagnosis) is unclear. We investigated the risk of CVD among 40,899 cancer survivors within the Korean National Health Insurance Service database. Exposure to PM was determined by assessing yearly average PM levels obtained from the Air Korea database from 2008 to 2011. PMs with sizes <2.5 (PM2.5), <10 (PM10), or 2.5–10 (PM2.5–10) μm in diameter were compared, with each PM level exposure further divided into quintiles. Patients were followed up from January 2012 to date of CVD event, death, or December 2017, whichever came earliest. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD were calculated using Cox proportional hazards regression by PM exposure levels. Compared with cancer survivors in the lowest quintile of PM2.5 exposure, those within the highest quintile had a greater risk for CVD (aHR 1.31, 95% CI 1.07–1.59). Conversely, increasing PM10 and PM2.5–10 levels were not associated with increased CVD risk (p for trend 0.078 and 0.361, respectively). Cancer survivors who reduce PM2.5 exposure may benefit from lower risk of developing CVD.

Context The relationship of ideal cardiovascular health (CVH) behaviors with preventing early-onset vasomotor symptoms (VMSs) is unknown. Objective We investigated the association between CVH metrics and the development of early-onset VMSs in premenopausal women. Design This cohort study included 2,541 premenopausal women aged 42–52 years without VMSs at baseline. Methods CVH metrics were defined according to the American Heart Association Life Simple 7 metrics. Due to the limited availability of dietary information, CVH metrics were scored from 0 (unhealthy) to 6 (healthy) and classified into three groups: poor (0–2), intermediate (3–4), and ideal (5–6) CVH. VMSs, including hot flashes and night sweats, were assessed using the Menopause-Specific Quality of Life questionnaire. Moderate/severe VMSs was defined as a score of ≥ 3 points (range: 0 to 6, 6 being most bothersome). Results During a median follow-up of 4.5 years, 1,241 women developed VMSs prior to menopause. After adjustment for age, parity, education level, and alcohol consumption, the hazard ratio (95% confidence interval [CI] ) for developing early-onset VMSs comparing poor CVH group to the ideal group was 1.41 (1.07–1.86). CVH scores were also inversely associated with moderate/severe VMSs in a dose-response manner (P for trend = 0.004); specifically, multivariate-adjusted hazard ratios comparing intermediate and poor CVH groups to the ideal group were 1.20 (95% CI: 1.02–1.43) and 1.57 (95% CI: 1.08–2.29), respectively. Conclusion Unfavorable CVH metrics were significantly associated with an increased risk of early-onset VMSs and its more severe forms among premenopausal women.